Does isolated and borderline isolated systolic hypertension increase the long-term risk of stroke in adults compared to normotension?
Both isolated and borderline isolated systolic hypertension are associated with a significantly increased long-term risk of stroke, including ischemic and intracerebral hemorrhage, compared to normotension.
BACKGROUND AND PURPOSE: Although the short-term risks of stroke and types of stroke associated with isolated systolic hypertension (ISH) and borderline isolated systolic hypertension (BISH) have been described, the long-term effects of these hypertensive conditions, particularly in younger individuals, are unclear. We performed this study to evaluate the long-term risks of stroke, type of stroke, and predictors of stroke associated with ISH and BISH and how this risk compares with that for persons with diastolic hypertension and normotension. METHODS: We used the 20-year follow-up data for 12 344 adults aged 25 to 74 years who participated in the First National Health and Nutrition Examination Survey Follow-Up Study to determine the aforementioned risks. Blood pressure (BP) measurements of the participants were obtained during baseline evaluation. ISH was defined as systolic BP >/=160 mm Hg and diastolic BP /=90 mm Hg. Normotension was defined as systolic BP /=180 mm Hg. CONCLUSIONS: Increased risks for stroke, ischemic stroke, and intracerebral hemorrhage were observed in patients with BISH, similar to those associated with ISH and diastolic hypertension. Future clinical trials are required to evaluate the effect of antihypertensive treatment in younger patients with BISH and ISH.
Qureshi et al. (Sun,) studied this question.